PracticeVideosBlogFlashcardsEspañol
All Practice Exams

100+ Free Examen Estatal de Medicina Interna Practice Questions

Prepare for the Examen Estatal de la Especialidad en Medicina Interna (Cuba) exam with instant access — no signup required.

✓ No registration✓ No credit card✓ No hidden fees✓ Start practicing immediately
100+ Questions
100% Free

Loading practice questions...

Same family resources

Explore More Cuban Medical & Dental Specialties State Exit Examinations (MINSAP Res. 108/2004)

Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.

Examen Estatal de la Especialidad — Pediatría (Cuba)

Practice Questions

Examen Estatal de la Especialidad — Anestesiología y Reanimación (Cuba)

Practice Questions

Examen Estatal de la Especialidad — Cardiología (Cuba)

Practice Questions

Examen Estatal de la Especialidad — Cirugía General (Cuba)

Practice Questions

Examen Estatal de la Especialidad — Estomatología General Integral (Cuba)

Practice Questions

Examen Estatal de la Especialidad — Ginecología y Obstetricia (Cuba)

Practice Questions

Sample Examen Estatal de Medicina Interna Practice Questions

Try these sample questions to test your Examen Estatal de Medicina Interna exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old male with essential hypertension presents to the internal medicine clinic with persistent blood pressure of 152/94 mmHg despite adherence to enalapril 20 mg daily. Under the Cuban National Program for Prevention, Diagnosis, Evaluation, and Control of Arterial Hypertension (HTA), what is the most appropriate next pharmacological step?
A.Switch enalapril to atenolol 50 mg once daily as monotherapy.
B.Add hydrochlorothiazide 12.5 to 25 mg once daily to enalapril.
C.Add spironolactone 100 mg daily as secondary line monotherapy.
D.Discontinue enalapril and initiate clonidine 0.1 mg twice daily.
Explanation: According to the Cuban Clinical Practice Guidelines for Arterial Hypertension (Programa Nacional de HTA), when target blood pressure (< 140/90 mmHg) is not achieved with monotherapy, combination therapy pairing an ACE inhibitor (enalapril) with a low-dose thiazide diuretic (hydrochlorothiazide 12.5-25 mg/day) is the first-line synergistic strategy. This combination addresses volume and renin-angiotensin mechanisms simultaneously.
2A 62-year-old male presents to the emergency room with 90 minutes of crushing retrosternal chest pain radiating to his left jaw. ECG reveals 3-mm ST-segment elevation in leads V1–V4. In a Cuban hospital setting without immediate percutaneous coronary intervention (PCI) availability, what is the established reperfusion protocol using recombinant streptokinase (Heberkinasa)?
A.1,500,000 IU administered intravenously over 60 minutes.
B.750,000 IU administered as a direct intravenous bolus over 2 minutes.
C.3,000,000 IU administered via continuous infusion over 24 hours.
D.500,000 IU administered subcutaneously twice daily.
Explanation: In Cuba, the national acute myocardial infarction protocol specifies fibrinolytic therapy with recombinant human streptokinase (Heberkinasa, produced by CIGB) at a standard dose of 1,500,000 international units diluted in 100 mL of 0.9% saline or 5% dextrose, administered intravenously over 60 minutes with continuous hemodynamic and rhythm monitoring.
3A 68-year-old female with chronic heart failure with reduced ejection fraction (HFrEF 30%, NYHA functional class III) is maintained on enalapril, carvedilol, and furosemide. Her serum potassium is 4.2 mEq/L and eGFR is 55 mL/min/1.73 m². To improve survival, which medication should be added according to international and Cuban cardiovascular protocols?
A.Digoxin 0.25 mg daily.
B.Spironolactone 25 mg daily.
C.Amlodipine 10 mg daily.
D.Diltiazem 60 mg three times daily.
Explanation: Mineralocorticoid receptor antagonists (MRAs), such as spironolactone (25 mg daily), are indicated for patients with HFrEF (ejection fraction ≤ 35%) with persistent symptoms despite ACE inhibitors and beta-blockers, provided eGFR > 30 mL/min and potassium < 5.0 mEq/L. MRAs demonstrate significant reduction in all-cause mortality and hospitalizations.
4A 74-year-old man presents with syncopal episodes. On physical examination, a harsh crescendo-decrescendo systolic ejection murmur is heard at the right second intercostal space radiating to the carotids, with a delayed and diminished carotid pulse (pulsus parvus et tardus) and a soft second heart sound. Which diagnostic test is the definitive gold standard for confirming the severity of this valvular lesion?
A.Transthoracic echocardiography.
B.Contrast-enhanced chest computed tomography.
C.Standard 12-lead electrocardiogram.
D.Holter ambulatory rhythm monitoring.
Explanation: The clinical findings of a crescendo-decrescendo murmur at the base radiating to carotids, parvus et tardus pulse, and single/soft S2 indicate severe aortic stenosis. Transthoracic echocardiography is the non-invasive gold standard to assess aortic valve area (< 1.0 cm² indicating severe disease), peak jet velocity (≥ 4.0 m/s), and mean transvalvular gradient (≥ 40 mmHg).
5A 45-year-old male with a prosthetic mechanical mitral valve presents with a 2-week history of low-grade fever, night sweats, fatigue, and new subungual splinter hemorrhages. Three separate sets of blood cultures yield Streptococcus gallolyticus (bovis). What mandatory concurrent screening procedure is required for this patient?
A.Total colonoscopy.
B.Upper gastrointestinal endoscopy.
C.Renal arteriography.
D.Lumbar puncture for cerebrospinal fluid analysis.
Explanation: Streptococcus gallolyticus (formerly Streptococcus bovis) infective endocarditis is strongly associated with gastrointestinal neoplasia, particularly colorectal adenomas and occult carcinomas (in up to 60% of cases). Once diagnosed, total colonoscopy is mandatory during hospitalization or early convalescence to rule out underlying colonic malignancy.
6A 32-year-old woman presents with sharp, retrosternal chest pain that worsens on deep inspiration and supine positioning and improves when sitting upright and leaning forward. Auscultation reveals a three-component pericardial friction rub. The ECG demonstrates diffuse concave upward ST-segment elevation with PR-segment depression in limb and precordial leads, and reciprocal PR elevation in lead aVR. What is the first-line pharmacotherapy?
A.Aspirin or NSAIDs combined with colchicine.
B.High-dose systemic corticosteroids monotherapy.
C.Intravenous unfractionated heparin.
D.Oral broad-spectrum fluoroquinolones.
Explanation: Acute pericarditis is managed first-line with high-dose aspirin (750-1000 mg every 8 hours) or NSAIDs (such as ibuprofen 600 mg every 8 hours) combined with colchicine (0.5 mg daily or twice daily for 3 months). Colchicine significantly reduces symptom persistence and halves the recurrence rate.
7A 71-year-old male with a history of long-standing hypertension presents with sudden, tearing chest pain radiating between his shoulder blades. Blood pressure is 195/110 mmHg in the right arm and 145/85 mmHg in the left arm. Contrast chest CT demonstrates an intimal flap originating in the descending thoracic aorta distal to the left subclavian artery (Stanford Type B dissection). What is the initial medical management goal?
A.Intravenous beta-blocker (e.g., labetalol) to achieve heart rate < 60 bpm and systolic BP 100–120 mmHg.
B.Immediate intravenous nitroprusside infusion alone without prior beta-blockade.
C.Subcutaneous enoxaparin 1 mg/kg every 12 hours.
D.Emergent surgical median sternotomy within 2 hours.
Explanation: The primary medical management of Stanford Type B aortic dissection is anti-impulse therapy: reducing heart rate (< 60 bpm) and shearing force (dP/dt) using IV beta-blockers (such as labetalol or esmolol), followed if necessary by vasodilators to achieve target systolic BP between 100 and 120 mmHg within 20 minutes.
8A 55-year-old female presents with sudden onset of palpitations, lightheadedness, and dyspnea. Her blood pressure is 115/75 mmHg. The 12-lead ECG demonstrates a regular narrow-complex tachycardia at 180 beats/min with absent discernible P waves. Vagal maneuvers fail to restore sinus rhythm. What is the immediate pharmacological agent of choice?
A.Adenosine 6 mg rapid IV bolus.
B.Amiodarone 300 mg IV over 30 minutes.
C.Lidocaine 1.5 mg/kg IV bolus.
D.Atropine 1 mg IV push.
Explanation: For stable, regular narrow-QRS paroxysmal supraventricular tachycardia (PSVT / AVNRT) refractory to vagal maneuvers, intravenous adenosine (6 mg rapid IV bolus followed by a 20 mL saline flush) is the first-line diagnostic and therapeutic drug, transiently blocking AV nodal conduction.
9A 64-year-old male with persistent non-valvular atrial fibrillation has a medical history of arterial hypertension, type 2 diabetes mellitus, and a previous ischemic stroke 2 years ago. According to the CHA2DS2-VASc score and international/Cuban cardiological consensus, what is his thromboprophylaxis recommendation?
A.Lifelong oral anticoagulation (vitamin K antagonist or DOAC).
B.Aspirin 100 mg daily monotherapy.
C.Dual antiplatelet therapy with aspirin and clopidogrel.
D.No antithrombotic therapy required.
Explanation: This patient has a CHA2DS2-VASc score of 5 (Hypertension = 1, Age 65-74 = 0, Diabetes = 1, Prior Stroke = 2, Age 64 = 0; total = 4 or 5 points depending on age tier, with prior stroke alone imparting 2 points). In any patient with prior stroke/TIA (CHA2DS2-VASc ≥ 2), oral anticoagulation (warfarin titrated to INR 2.0-3.0 or a direct oral anticoagulant) is strongly indicated to reduce thromboembolic risk.
10A 60-year-old woman with chronic hypertension presents to the emergency department with severe dyspnea, orthopnea, and pink frothy sputum. Physical examination reveals bilateral pulmonary crackles halfway up the lung fields, an S3 gallop, blood pressure of 210/120 mmHg, and oxygen saturation of 82% on room air. Alongside high-flow oxygen and intravenous loop diuretics, which intravenous vasodilator is most effective for rapid preload and afterload reduction?
A.Nitroglycerin continuous intravenous infusion.
B.Dobutamine continuous intravenous infusion.
C.Noradrenaline continuous intravenous infusion.
D.Epinephrine subcutaneous injection.
Explanation: In acute hypertensive pulmonary edema, intravenous nitroglycerin is the vasodilator of choice. At standard to high titration, it produces both venodilation (preload reduction, clearing pulmonary congestion) and arteriolar dilation (afterload reduction, decreasing left ventricular impedance), rapidly breaking the decompensation cascade.

About the Examen Estatal de Medicina Interna Exam

The Examen Estatal de la Especialidad en Medicina Interna is the culminating credentialing milestone for postgraduate medical residents completing Cuba's 3-year national residency programme in Internal Medicine, qualifying graduates as Especialista de Primer Grado en Medicina Interna. Medicina Interna is one of Cuba's three fundamental basic clinical specialties (especialidades básicas). Administered biannually in April-May and October-November under MINSAP Resolución Ministerial No. 108/2004, the examination is conducted by external national or provincial tribunals ('tribunales cruzados'). The graduation assessment integrates academic record scoring, defense of the Trabajo de Terminación de la Especialidad (TTE), and state practical and theoretical exercises covering the 18 modules of the 2015 national curriculum (including mandatory modules in Medicina Natural y Tradicional and Imagenología). This practice bank is an English-language MCQ study adaptation built from the official Cuban specialty programme objectives issued by the Ministerio de Salud Pública (MINSAP). It is not an official translation, not a simulation of the practical, oral, or thesis defence exercises, and not a substitute for clinical performance practice.

Assessment

The graduation evaluation (Evaluación de Graduación) consists of three mandatory components: (1) Final Academic Transcript Evaluation (Calificación Final del Expediente); (2) Thesis defense (Trabajo de Terminación de la Especialidad - TTE); and (3) Examen Estatal, comprising an Ejercicio Teórico-Práctico (direct bedside inpatient evaluation with full clinical history, diagnostic discussion, and therapeutic management defense) and an Ejercicio Teórico (oral or written examination of 5 to 10 generalizing clinical questions evaluated by an external national or provincial tribunal).

Time Limit

Multi-day schedule convened twice annually (April-May and October-November)

Passing Score

70% of the marks assigned by the plan de estudios (MINSAP Res. 108/2004 Art. 116)

Exam Fee

There is no candidate sitting fee for Cuban nationals (postgraduate medical residency in Cuba is state-funded and salaried). Self-financed international residents pay tuition through Servicios Médicos Cubanos (SMC), which covers all examinations including the final state exam. (Ministerio de Salud Pública de Cuba (MINSAP) — Dirección de Docencia Médica)

Examen Estatal de Medicina Interna Exam Content Outline

~20% of this local bank

Cardiovascular and Respiratory Disorders

Arterial hypertension (Cuban guidelines), acute coronary syndromes, heart failure, arrhythmias, valvular heart disease, community-acquired pneumonia, COPD, asthma, pleural effusion, and pulmonary tuberculosis (National TB Control Program).

~15% of this local bank

Gastroenterology, Hepatology, and Nephrology

Upper and lower GI bleeding, peptic ulcer disease, cirrhosis and portal hypertension, acute and chronic hepatitis, acute pancreatitis, acute kidney injury, chronic kidney disease (KDIGO), glomerular syndromes, and fluid, electrolyte, and acid-base disturbances.

~15% of this local bank

Endocrinology, Metabolism, and Hematology

Diabetes mellitus (Cuban clinical guidelines), diabetic emergencies (DKA, HHS), thyroid and adrenal disorders, metabolic syndrome, anemias, sickle cell disease (drepanocitosis protocols), leukemias, lymphomas, and coagulopathies.

~15% of this local bank

Infectious Diseases and Epidemiology

Dengue fever (MINSAP/IPK clinical staging and fluid protocols), leptospirosis, HIV/AIDS and opportunistic infections, cholera, malaria, hospital-acquired infections, and rational antimicrobial therapy.

~15% of this local bank

Neurology, Rheumatology, and Clinical Immunology

Ischemic and hemorrhagic stroke, status epilepticus, bacterial and viral meningoencephalitis, Guillain-Barré syndrome, systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, vasculitis, and anaphylaxis.

~10% of this local bank

Critical Care, Emergencies, and Geriatric Medicine

Septic shock, cardiogenic shock, cardiopulmonary resuscitation (ACLS/BLS), acute poisoning (organophosphates), comprehensive geriatric assessment, delirium, polypharmacy, and oncologic emergencies.

~10% of this local bank

Medicina Natural y Tradicional (MNT) and Diagnostic Procedures

MINSAP-approved herbal medicines (phytotherapy), acupuncture and moxibustion indications, diagnostic imaging interpretation (CXR, abdominal ultrasound, CT), ECG analysis, and invasive bedside procedures (thoracentesis, paracentesis, lumbar puncture, central venous access).

How to Pass the Examen Estatal de Medicina Interna Exam

What You Need to Know

  • Passing score: 70% of the marks assigned by the plan de estudios (MINSAP Res. 108/2004 Art. 116)
  • Assessment: The graduation evaluation (Evaluación de Graduación) consists of three mandatory components: (1) Final Academic Transcript Evaluation (Calificación Final del Expediente); (2) Thesis defense (Trabajo de Terminación de la Especialidad - TTE); and (3) Examen Estatal, comprising an Ejercicio Teórico-Práctico (direct bedside inpatient evaluation with full clinical history, diagnostic discussion, and therapeutic management defense) and an Ejercicio Teórico (oral or written examination of 5 to 10 generalizing clinical questions evaluated by an external national or provincial tribunal).
  • Time limit: Multi-day schedule convened twice annually (April-May and October-November)
  • Exam fee: There is no candidate sitting fee for Cuban nationals (postgraduate medical residency in Cuba is state-funded and salaried). Self-financed international residents pay tuition through Servicios Médicos Cubanos (SMC), which covers all examinations including the final state exam.

Keys to Passing

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

Examen Estatal de Medicina Interna Study Tips from Top Performers

1Rigidly apply the clinical method (el método clínico como método científico de la medicina), emphasizing detailed anamnesis and meticulous physical examination before requesting diagnostic tests.
2Review official Cuban clinical practice guidelines, particularly the Programa Nacional de Prevención, Diagnóstico, Evaluación y Control de la Hipertensión Arterial, GPC de Diabetes Mellitus, and IPK/MINSAP Dengue and Leptospirosis protocols.
3Master the management of endemic and regional conditions prevalent in Cuban hospitals, including dengue warning signs and fluid titration, leptospirosis antimicrobial regimens, and sickle cell disease (drepanocitosis) vaso-occlusive and acute chest syndrome crises.
4Consolidate core competencies in the obligatory modules of Imagenología (systematic chest X-ray and emergency ultrasound interpretation) and Medicina Natural y Tradicional (MINSAP-approved phytopharmaceuticals, acupuncture, and ozone therapy).

Frequently Asked Questions

What is the official structure of the Cuban Examen Estatal in Internal Medicine?

Under MINSAP Resolución Ministerial No. 108/2004 (Capítulo VI, Arts. 115-118), the evaluation of graduation consists of three components: (1) Final Academic Transcript Evaluation (Expediente); (2) Evaluation of the Trabajo de Terminación de la Especialidad (TTE thesis and defense); and (3) The Examen Estatal itself, which includes a clinical practical examination (ejercicio teórico-práctico) performing a full inpatient history, examination, and case defense before an external tribunal, plus a theoretical examination (ejercicio teórico) of 5 to 10 generalizing clinical questions. This practice bank is an English-language MCQ study adaptation built from the official Cuban specialty programme objectives issued by the Ministerio de Salud Pública (MINSAP). It is not an official translation, not a simulation of the practical, oral, or thesis defence exercises, and not a substitute for clinical performance practice.

What is the passing score for the Examen Estatal in Cuba?

According to Article 116 of MINSAP Resolution 108/2004, every component (academic record, thesis defense, and practical/theoretical state examination) must be passed with a minimum score of 70% of the maximum marks allocated by the Plan de Estudios. Failing any component requires repeating that evaluation in its entirety, with a maximum attainable mark of 70% upon re-examination (Art. 121).

When and how are the tribunals convened?

Under Article 109 of Resolution 108/2004, state examinations are convened twice annually in April-May and October-November. The tribunals (Tribunales Estatales) may be provincial or national and are composed of external senior internists and academic specialists ('tribunales cruzados') designated by MINSAP to guarantee objectivity (Arts. 110-111).

What are the fees to sit the Cuban Internal Medicine State Exam?

There is no candidate sitting fee for Cuban citizens, as postgraduate medical education in Cuba is state-funded and residents receive a salary throughout their 3-year training. Self-financed international residents pay tuition via Servicios Médicos Cubanos (SMC), which encompasses all examination and graduation administrative costs.

Is this 100-question practice test an official MINSAP examination?

No. This practice bank is an English-language MCQ study adaptation built from the official Cuban specialty programme objectives issued by the Ministerio de Salud Pública (MINSAP). It is not an official translation, not a simulation of the practical, oral, or thesis defence exercises, and not a substitute for clinical performance practice. It is designed as an educational tool to test core knowledge across the 18 modules of the Cuban internal medicine curriculum.